Decortication Mesothelioma: Different Ways To Remedy

Approaches to treatment of malignant mesothelioma consist of curative procedures and practices of palliative care.

As the label suggests, potentially curative procedures, to improve the patients 'disease'. The main objective of these procedures for the complete removal of serious illness. Microscopic residual disease is typically blown out of the use of adjuvant therapy is usually in the form of a combination of chemotherapy and radiotherapy. Studies have shown that the approach trimodality, combining surgery with radiotherapy and chemotherapy or other novel approaches, such as gene therapy, photodynamic therapy, or immunotherapy are effectively come to a cure.

An example of a potentially curative procedure for mesothelioma is pleural pleurectomy or decortication. This is usually done in patients who are in stages I and II malignant mesothelioma. The removal of all gross tumor is attempted this procedure. If complete removal of the tumor requires removal of the lung and pneumonectomy was performed at the same time.

A more radical approach that can potentially be used to treat pleural mesothelioma is an extrapleural pneumonectomy. As this is a more radical, more experience is required of surgeons. Patients must meet certain criteria before extrapleural pneumonectomy can be performed on them. These criteria included a Karnofsky performance score of the State of> 70 years, renal and liver function if in a normal electrocardiogram and the results of an echocardiogram, pulmonary function tests properly, limiting disease in the entire ipsilateral hemithorax or without any involvement of the wall of the diaphragm, heart or chest, and patient age. The age is not given as much weight as the patient's overall functional status.

For peritoneal mesothelioma, a tumor reduction surgery is performed to finally make a recovery. As with the methods used for pleural mesothelioma, this is done to remove all gross tumor. Cytoreductive surgery is usually combined with hyperthermic intraperitoneal chemotherapy (IPHC), which aims to eliminate any remaining microscopic cancer cells.

For patients with advanced stages of malignant mesothelioma of the above approaches to healing are not warranted, treatment should be directed to the use of palliative procedures.

Palliative procedures are designed to relieve symptoms caused by the disease in hopes of improving the quality of life for patients. Thoracic drainage and pleurodesis is a palliative treatment used to relieve joint fluid accumulation or effusion in the chest cavity. Since a malignant pleural effusion is usually persistent, after the initial drainage, pleurodesis is often made to permanently close the pleural space and prevent fluid re-accumulation. Talcum powder or other sclerosing agents are used as glue. Thoracoscopy with pleurodesis have another palliative procedure with a similar strategy. Both procedures can be done if the tumor has not encapsulated lungs. The unlimited capacity for expansion of the lungs must be intact for both procedures. In cases where the disease is limiting the expansion of the lung, a pleurectomy is the most effective treatment means to control the pleural effusion.

Pleuroperitoneal shunt is another palliative procedure, a catheter position, the thread under the skin of the patient's pleural and peritoneal cavities. This is not a very popular option for palliative care due to possible obstruction of the catheter and the seeding of tumor in different cavities.

The choice of treatment options for malignant mesothelioma is depending on the stage of the patient's disease at diagnosis. Rapid recognition of symptoms and diagnosis in a timely manner is still needed before these treatments can be implemented.